Practical 5 Posterior Mediastinum & Review PDF (Feb 10, 2021)

Practical 5 Posterior Mediastinum & Review Dr Eva Sweeney (Wed 10 Feb 2021) ❑ Identify and describe the azygos system of veins ❑ Identify and describe the anatomy and course of the thoracic duct ❑ Identify and describe the sympathetic chain Posterior Mediastinum...

Practical 5 Posterior Mediastinum & Review Dr Eva Sweeney (Wed 10 Feb 2021) ❑ Identify and describe the azygos system of veins ❑ Identify and describe the anatomy and course of the thoracic duct ❑ Identify and describe the sympathetic chain Posterior Mediastinum Contents: “DATES In Vagus” ❑ Descending thoracic aorta ❑ Azygos & hemiazygos veins ❑ Thoracic Duct ❑ oEsophagus ❑ Sympathetic trunk ❑ Intercostal vessels (posterior) ❑ Vagus nerves Posterior Mediastinum Costal Mediastinal parietal parietal pleura & pleura pericardium Diaphragmatic parietal pleura Lateral view of LEFT mediastinum Lateral view of RIGHT mediastinum Left aspect of mediastinum Right aspect of mediastinum Descending Thoracic Aorta Parts of the Aorta: Ascending aorta Arch of aorta Descending thoracic aorta Ao (runs from T4 – T12) Abdominal Aorta Oe It is posterior to root of left lung & oesophagus. As it descends it runs toward the midline. Runs through aortic hiatus of diaphragm at T12 level Descending Thoracic Aorta: Branches Common carotid Costocervical trunk: (a branch of subclavian a) this gives a supreme intercostal branch that divides into 1-2nd posterior intercostal aa In most people, a lower post. intercostal aa supplies the great 3-11th Posterior intercostal & subcostal aa anterior radiculomedullary artery (of Adamkiewicz), an important blood supply of the spinal cord Bronchial aa (on the R this is an indirect branch from a post. intercostal a) Unpaired branches arising anteriorly: Oesophageal Mediastinal: supply areolar tissues & lymph nodes Pericardial Superior phrenic: paired, run on superior surface of diaphragm → Thoracic Aortic Aneurysms & Aortic Dissection A ballooning of a weakened part of the aorta, often asymptomatic unless they rupture, dissect or compress structures (e.g., L recurrent laryngeal nerve-hoarseness, oesophagus-dysphagia, bronchus-cough, dyspnoea) Abdominal Large aneurysms aortic treated with aneurysm endovascular stent (AAA) is graft or open much more repair common than thoracic Aortic root & Aortic Descending aneurysm Ascending aorta arch aorta 6% & 1% aneurysms aneurysm aneurysm older men & women (60% of thoracic (